논문 상세보기

대한내과학회> 대한내과학회지 (Korean J Med)> 증례 : 소화기 ; 총담관-십이지장 누공을 동반한 담관 내 점액성 유두 종양

KCI후보

증례 : 소화기 ; 총담관-십이지장 누공을 동반한 담관 내 점액성 유두 종양

Case Reports : Gastroenterology ; Intraductal Papillary Mucinous Neoplasm of the Bile Ducts Accompanied by a Choledochoduodenal Fistula

김형태 ( Hyung Tae Kim ) , 김사일 ( Sa Il Kim ) , 권오완 ( Oh Wan Kwon ) , 이항락 ( Hang Lak Lee ) , 전대원 ( Dae Won Jun ) , 이오영 ( Oh Young Lee ) , 최호순 ( Ho Soon Choi )
  • : 대한내과학회
  • : 대한내과학회지 (Korean J Med) 81권1호
  • : 연속간행물
  • : 2011년 07월
  • : 93-97(5pages)
대한내과학회지 (Korean J Med)

DOI


목차


					

키워드 보기


초록 보기

담관 내 점액성 유두 종양이 다른 장기와 누공을 형성한 증례보고는 저자들이 문헌고찰한 것에 의하면 없으며, 누공형성 기전도 확립된 것이 없어 더 많은 보고와 연구가 필요하다. 저자들은 황달과 가려움증으로 내원하여 총담관-십이지장 누공을 동반한 담관 내 점액성 유두 종양을 진단하였으며, 간좌엽 절제술 및 담낭절제술로 치료한 증례를 경험하여 보고한다.
An intraductal papillary mucinous neoplasm of the bile ducts (IPMN-B) is an uncommon tumor characterized by the secretion of large amounts of mucin and intraductal growth. The characteristic clinical symptoms and radiologic findings are due to bile-duct obstruction caused by mucin. A parapapillary choledochoduodenal fistula is a rare disorder. This fistula has no clinical symptoms and is diagnosed by chance. We report a case of parapapillary choledochoduodenal fistula associated with IPMN-B. A 63-year-old woman was admitted to Hanyang University Hospital because of jaundice. Computed tomography (CT) showed diffuse intra- and extrahepatic bile duct dilatation. The ducts were filled with heterogenous material. Duodenoscopy revealed a large choledochoduodenal fistula. Endoscopic retrograde cholangiography through the fistula showed a papillary mass in the common hepatic duct. IPMN-B with choledochoduodenal fistula was diagnosed. The patient underwent a left hepatectomy. Her postoperative course was uneventful, and she was observed regularly in the outpatient department. (Korean J Med 2011;81:93-97)

UCI(KEPA)

I410-ECN-0102-2012-510-002056317

간행물정보

  • : 의약학분야  > 내과학
  • : KCI후보
  • :
  • : 격월
  • : 1738-9364
  • : 2289-0769
  • : 학술지
  • : 연속간행물
  • : 1949-2022
  • : 12186


저작권 안내

한국학술정보㈜의 모든 학술 자료는 각 학회 및 기관과 저작권 계약을 통해 제공하고 있습니다.

이에 본 자료를 상업적 이용, 무단 배포 등 불법적으로 이용할 시에는 저작권법 및 관계법령에 따른 책임을 질 수 있습니다.

97권5호(2022년 10월) 수록논문
최근 권호 논문
| | | |

KCI후보

1포스트 코로나 신종감염병: 다음 대유행의 주인공은 누구인가?

저자 : 최영화 ( Young Hwa Choi )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 277-283 (7 pages)

다운로드

(기관인증 필요)

초록보기

Emerging infectious diseases are increasing recently and globally. We have a long list of infectious disease epidemic in the 21th century followed by SARS, MERS, Ebola virus disease, and Zika virus infection. COVID-19 is a still ongoing pandemic. What will be the next pandemic agent? The World Health Organization proposed a research and development blueprint regarding global pandemic in 2016. The United Kingdom maintains a list of high consequence infectious diseases and is monitoring them. The Republic of Korea designates Class 1 infectious diseases capable of causing outbreak or epidemic. This article briefly describes several infectious diseases and its causative pathogen that should receive special attention. (Korean J Med 2022;97:277-283)

KCI후보

2포스트 코로나증후군

저자 : 차재명 ( Jae Myung Cha )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 284-291 (8 pages)

다운로드

(기관인증 필요)

초록보기

Although acute COVID-19 usually lasts for 12 weeks from the onset of symptoms, some patients experience variable persistent symptoms. Post-COVID-19 syndrome is defined as persistent symptoms and/or long-term complications that appear during or after COVID-19, persist for more than 12 weeks, and cannot be explained by an alternative diagnosis. The common symptoms of post-COVID-19 syndrome include general, pulmonary, hematological, cardiovascular, neuropsychiatric, renal, endocrine, gastroenterological, and dermatological symptoms. As the natural course and pathophysiology of COVID-19 are not yet clear, close monitoring is needed for various sequelae in multiple organs that occur in post-COVID-19 syndrome. In particular, patients who have been hospitalized in the intensive care unit or who have recovered from severe COVID-19 require close monitoring for the development of post-COVID-19 syndrome. Multidisciplinary collaboration is essential to provide integrated outpatient care for patients with post-COVID-19 syndrome. (Korean J Med 2022;97:284-291)

KCI후보

3새로운 권고안(2021 Korean Thyroid Imaging Reporting and Data System)을 이용한 갑상선 결절의 평가

저자 : 정소령 ( So Lyung Jung )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 292-302 (11 pages)

다운로드

(기관인증 필요)

초록보기

The rate of detection of thyroid nodules and carcinomas has increased with the widespread use of ultrasonography (US), which is the primary imaging modality for the detection and risk stratification of thyroid nodules. The appropriate diagnosis and management of these patients is based on the risk factors related to the patients as well as the thyroid nodules. The Korean Society of Thyroid Radiology (KSThR) published consensus recommendations for US-based management of thyroid nodules in 2011 and revised them in 2016. These guidelines have been used as the standard guidelines in Korea. However, recent advances in the diagnosis and management of thyroid nodules have necessitated the revision of the original recommendations. The task force of the KSThR has revised the Korean Thyroid Imaging Reporting and Data System and recommendations for US lexicon, biopsy criteria, US criteria of extrathyroidal extension, optimal thyroid computed tomography protocol, and US follow-up of thyroid nodules before and after biopsy. The biopsy criteria were revised to reduce unnecessary biopsies for benign nodules while maintaining an appropriate sensitivity for the detection of malignant tumors. The goal of these recommendations is to provide the optimal scientific evidence and expert opinion consensus regarding US-based diagnosis and management of thyroid nodules. (Korean J Med 2022;97:292-302)

KCI후보

4성공적인 입원전담전문의 시스템의 정착과 성장을 위한 경영 전략

저자 : 이종찬 ( Jongchan Lee )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 303-307 (5 pages)

다운로드

(기관인증 필요)

초록보기

Appropriate management strategies are required to establish, maintain, and promote the growth the hospitalist system. Herein, we discuss strategies for the successful operation of the hospitalist system from the business point of view, particularly in terms of human resources and organizational management. Hospital executives should establish the vision, mission, value, and key value drivers of the hospitalist system from its inception, as well as decide its size and operation pattern according to the situation of each medical institution. Hospitalists are employed through the process of recruitment to increase the number of applicants and allow the selection of suitable candidates. Once the hospitalist system is constructed and operational, the focus must shift toward its growth. The goals and strategies for growth should be decided, leaders must be selected, and assistants must be employed. In the future, the hospitalist system is expected to play an essential role in improving the quality of medical care. Therefore, medical institutions should strategically introduce, maintain, and promote the growth of the hospitalist system. (Korean J Med 2022;97:303-307)

KCI후보

5혈액종양의 세계보건기구 분류에 근거한 급성골수성백혈병의 진단적 접근

저자 : 조영욱 ( Young-uk Cho )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 308-318 (11 pages)

다운로드

(기관인증 필요)

초록보기

Acute myeloid leukemias (AMLs) are heterogeneous hematologic neoplasms characterized by myeloblast or promyelocyte proliferation without normal differentiation. The World Health Organization (WHO) classifies AMLs on the basis of chromosomal and genetic aberrations, with different prognoses for each subtype. Therefore, accurate diagnosis and classification of AMLs is critical for timely and appropriate treatment. Initial diagnostic workup includes morphologic assessment of the bone marrow aspirate and trephine biopsies, immunophenotyping using flow cytometry or immunohistochemistry stains, chromosomal analysis using the G-banding technique or fluorescence in situ hybridization, and mutation analysis using polymerase chain reaction, direct sequencing, or next-generation sequencing. The present study provides an algorithm for AML diagnosis and classification based on the WHO criteria and describes different clinicopathological stages of the workup. (Korean J Med 2022;97:308-318)

KCI후보

6분자종양위원회의 임상적 실제

저자 : 이수현 ( Soohyeon Lee )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 319-322 (4 pages)

다운로드

(기관인증 필요)

초록보기

Due to rapid technical advances, steeply declining sequencing costs, and the ever-increasing number of targeted therapies, it is expected that extensive tumor DNA or RNA sequencing will be applied in standard of care. Clinicians will thus be confronted with increasingly complex genetic information and multiple test-platforms to choose from. General medical training, meanwhile, can hardly keep up with the pace of innovation. Consequently, there is a rapidly growing gap between clinical knowledge and genetic potential in cancer care. Multidisciplinary Molecular Tumor Boards (MTBs) have been suggested as a means to address this disparity, as a multidisciplinary approach to keep pace with the growing knowledge of complex molecular alterations in patients with advanced solid cancer. MTBs are designated to interpret these data and provide clinical recommendations. Not all patients with cancer have access to advice of an MTB. We aimed to determine the current status, opportunities, and challenges of the organization of MTBs in the Korea. (Korean J Med 2022;97:319-322)

KCI후보

7심장 내 이물질로 인한 반복적인 뇌경색 발생에 관한 증례

저자 : 유지웅 ( Jiwung Ryu ) , 김중선 ( Jung-sun Kim ) , 서지원 ( Jiwon Seo )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 323-327 (5 pages)

다운로드

(기관인증 필요)

초록보기

We present a case of recurrent ischemic stroke in a 68-year-old man with a linear foreign body in the right atrium and ventricle and a patent foramen ovale (PFO). The patient developed atrial fibrillation despite taking warfarin at a therapeutic dose and had a third acute stroke. We planned left atrial appendage (LAA) occlusion via the PFO, followed by PFO closure and foreign body removal. The percutaneous LAA occlusion and PFO closure were successful. However, it was difficult to remove the radiolucent foreign body. We inserted an Omni™ catheter via the right jugular vein to contact the foreign body in the right atrium directly, grasped its distal end with a snare, and successfully extracted it. The patient was followed-up in the outpatient clinic and had no recurrent stroke. (Korean J Med 2022;97:323-327)

KCI후보

8MTHFR 유전자 변이와 헤파린 유도 혈소판감소증이 동반된 환자에서의 성공적 생체 신장 이식 1예

저자 : 강동혁 ( Donghyuk Kang ) , 이한비 ( Hanbi Lee ) , 정병하 ( Byung Ha Chung ) , 최범순 ( Bum Soon Choi ) , 양철우 ( Chul Woo Yang ) , 고은정 ( Eun Jeong Ko )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 328-333 (6 pages)

다운로드

(기관인증 필요)

초록보기

본 증례는 혈전 발생 위험도가 높은 MTHFR 유전자 변이와 헤파린유도 혈소판 감소증 두 질환을 동시에 가진 말기신부전 환자에서 신장 이식을 진행함에 있어, 수술 전후 혈전증 및 출혈을 최소화하는 개별화된 특수 항응고 치료 프로토콜을 적용하여 특이 합병증 없이 신장이식에 성공한 바, 이에 문헌고찰과 함께 보고하는 바이다.


Perioperative anticoagulation in a kidney transplant recipient with heparin-induced thrombocytopenia is challenging due to paradoxical hypercoagulability. A 49-year-old man with end-stage kidney disease and a previous stroke history was referred for living donor kidney transplantation. After the fifth dialysis session, the platelet count decreased to 10,000/μL, and heparin was immediately discontinued. Five days later, pulmonary thromboembolism with deep vein thrombosis was identified. Anti-heparin PF4 antibody, elevated serum homocysteine, and methylenetetrahydrofolate reductase gene mutations were discovered. Subsequent coronary angiography revealed three-vessel disease. Apixaban, folate, aspirin, and clopidogrel were administered and an inferior vena cava filter was implanted. Thereafter, coronary artery bypass graft surgery was performed using argatroban-bridging without complications. Kidney transplantation was performed 3 months later using the argatroban protocol. The graft kidney functioned well without any complications. In conclusion, we successfully conducted kidney transplantation in a thrombophilic patient with a methylenetetrahydrofolate reductase deficiency and heparin-induced thrombocytopenia by establishing an individualized perioperative anticoagulation protocol. (Korean J Med 2022;97:328-333)

1
권호별 보기
같은 권호 다른 논문
| | | | 다운로드

KCI후보

1위축성 위염 혹은 위암에 미치는 프로톤펌프억제제의 영향: Safe 측면

저자 : 박홍준 ( Hong Jun Park ) , 김현수 ( Hyun Soo Kim )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 81권 1호 발행 연도 : 2011 페이지 : pp. 1-5 (5 pages)

다운로드

(기관인증 필요)

초록보기

Proton pump inhibitors (PPIs) are widely used over 20 years for management of symptoms due to acid related diseases such aspeptic ulcer and reflux esophagitis. Serious adverse events are extremely rare for short-term PPIs use. Recently, as long-term PPIsuse increase, diverse reports have been reported on adverse event related with long-term PPIs use. Long-term PPIs use is generally referred as use of PPIs more than 1 year. Secondary hypergastrinemia after long-term PPIs use is associated with development of fundic gland polyps (FGP) and hyperplasia of enterochromaffin-like cell (ECL) that might be concerned with gastric carcinoid tumor. Furthermore, several studies have posed the relationship between the risk of gastric cancer and long-term PPIs use with co-existing H. pylori infection. The present review summarize the recent accumulated evidence on neoplasm associated withsecondary hypergastrinemia after long-term PPIs use. (Korean J Med 2011;81:1-5)

KCI후보

2위축성 위염 혹은 위암에 미치는 프로톤펌프억제제의 영향: Unsafe 측면

저자 : 송창석 ( Chang Seok Song ) , 박동일 ( Dong Il Park )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 81권 1호 발행 연도 : 2011 페이지 : pp. 6-10 (5 pages)

다운로드

(기관인증 필요)

초록보기

Proton-pump inhibitors (PPI) have important roles in the management of acid-related disorders, especially gastro-esophageal reflux disease and peptic ulcer disease. They are considered safe, but some side effects, such as oxyntic cell hyperplasia, glandular cysts, hypergastrinemia and fundic gland polyps, are also reported. Long-term PPI administration in Helicobacter pylori (H. pylori) positive subjects promotes a shift from antral to corpus-predominant gastritis. The shift leads to corpus atrophy eventually that is known predisposing factor of gastric adenocarcinoma. It is recommended that patients being considered for long-term PPI therapy should be tested for H. pylori infection. And if present, H. pylori eradication should be preceded to PPI administration. Also, long-term PPI administration can cause enterochromaffin-like cell hyperplasia. Although the underlying mechanism and pathogenesis are not yet fully understood, it is possible that long-term PPI administration can promote the development of gastric carcinoid tumor. Therefore, to minimize the side effects, it should be used in adequate dose for a precise duration. (Korean J Med 2011;81:6-10)

KCI후보

3영양, 대사 및 감염에 미치는 프로톤펌프억제제의 영향: Safe 측면

저자 : 김지현 ( Jie Hyun Kim )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 81권 1호 발행 연도 : 2011 페이지 : pp. 11-16 (6 pages)

다운로드

(기관인증 필요)

초록보기

Proton pump inhibitors (PPIs) have been widely used to treat patients with acid-related disorders because they are perceived to besafe and effective. However, they have the potential for side effects. Many studies have examined the side effects of long-term PPI exposure. We review the side effects of long-term PPIs, focusing on nutrition, metabolism, and infection. (Korean J Med 2011;81:11-16)

KCI후보

4영양, 대사 및 감염에 미치는 프로톤펌프억제제의 영향: Unsafe 측면

저자 : 차봉기 ( Bong Ki Cha ) , 최창환 ( Chang Hwan Choi )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 81권 1호 발행 연도 : 2011 페이지 : pp. 17-25 (9 pages)

다운로드

(기관인증 필요)

초록보기

Proton pump inhibitors (PPI) are very effective drug used frequently in acid-related disorders. Long-term use of PPI is becoming increasingly common, often without appropriate indications. The debate had focused on the adverse effects related to long-term use of PPI during the last years. This article is a detailed review of the evidence on this topic, focusing on the adverse effects of long-term PPI use that have developed the greatest concern; vitamin B12 deficiency, iron deficiency, impaired calcium absorption,bony fracture, hypomagnesemia, increased susceptibility to pneumonia and enteric infections. Although PPIs have been used with a high margin of safety, the clinicians should consider reducing the dose of PPIs and reassessing the treatment duration to prevent adverse effects of PPIs. (Korean J Med 2011;81:17-25)

KCI후보

5항혈소판제제를 포함한 약물상호작용에 미치는 프로톤펌프억제제의 영향: Safe 측면

저자 : 조윤주 ( Yun Ju Jo )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 81권 1호 발행 연도 : 2011 페이지 : pp. 26-33 (8 pages)

다운로드

(기관인증 필요)

초록보기

Clopidogrel prevent atherothrombotic complications following acute coronary syndromes by inhibiting platelet aggregation.However, in case of concomitant use of clopidogrel and proton pump inhibitor (PPI) for prophylaxis of gastrointestinal (GI)bleeding, the anti-clotting of clopidogrel will be decreased because PPI inhibit competitively cytochrome P450 enzymes, especially CYP2C19. Through several pharmacodynomic studies, omeprazole, but not other PPIs, worsens surrogate markers (e.g., platelet reactivity index) of clopidogrel efficacy. And many observational studies show concomitant use of clopidogrel and PPI have increased the risks of cardiovascular (CV) events (hazard/odds ratios=1.25-1.5). However, only one prospective randomized trial (COGENT trial) of omeprazole vs. placebo in clopidogrel users show no difference in CV events (hazard ratio=1.02) and decrease the risk of GI bleeding (hazard ratio=0.13). Further well designed research will need to determine whether a pharmacodynamic effect of clopidogrel affected by PPI will be changed clinical CV events. Clinical decisions about concomitant use of PPI and clopidogrel must be balance overall risks and benefits, considering both CV and GI complications. (Korean J Med 2011;81:26-33)

KCI후보

6항혈소판제제와 프로톤펌프억제제 간의 약물 상호 작용: Unsafe 측면과 대책

저자 : 이경훈 ( Kyounghoon Lee ) , 한승환 ( Seung Hwan Han )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 81권 1호 발행 연도 : 2011 페이지 : pp. 34-39 (6 pages)

다운로드

(기관인증 필요)

초록보기

Clopidogrel is a prodrug that is converted in the liver to an active thiol metabolite, which irreversibly inhibits the platelet P2Y12 adenosine diphosphate receptor. This mechanism requires cytochrome P450 2C19 (CYP 2C19) enzyme. Proton pump inhibitors(PPIs) competes against CYP 2C19 and inhibits the conversion of clopidogrel into its active metabolite, therefore, clopidogrel-PPIs drugs interaction may exist. These interactions could result in competitive inhibition decreasing the conversion of the clopidogrel pro-drug to the active metabolite and could potentially translate into an increased risk for cardiovascular events by inadequate platelet P2Y12 receptor inhibition. Many studies including retrospective cohort studies and studies using platelet function tests demonstrated the possible interactions between clopidogrel and PPIs leading to a decrease in the antiplatelet efficacy of clopidogrel and worse cardiovascular clinical outcomes than clopidogrel alone. In contrast, few comparative trials using clinical outcomes found no serious drug interactions between them. In this review, we introduce possible harmful effects of combined use of clopidogrel and PPIs on platelet function. In addition, we suggest how to overcome clopidogrel-PPIs interactions. (Korean J Med 2011;81:34-39)

KCI후보

7종설 : 조기위암의 내시경치료

저자 : 최기돈 ( Kee Don Choi )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 81권 1호 발행 연도 : 2011 페이지 : pp. 40-46 (7 pages)

다운로드

(기관인증 필요)

초록보기

Endoscopic resection has become accepted as a standard treatment in selected patients with early gastric cancer (EGC) with negligible risk of lymph node metastasis. Endoscopic resection preserves the stomach and therefore improves quality of life compared with surgery. And it allows accurate histological staging of the tumor, which is critical in deciding whether additional treatment is necessary. The endoscopic submucosal dissection (ESD) method has been widely used with higher en bloc resection and complete resection rates than conventional endoscopic mucosal resection (EMR) with acceptable complication rates. Long-term clinical outcomes of these techniques are promising in terms of disease-free and overall survival. Recently, the expanded indication of endoscopic resection for early gastric cancer has been proposed because of technical advances of ESD. Long-term outcome data of the expanded indication are needed for the clinical application of the expanded criteria of ESD. (Korean J Med 2011;81:40-46)

KCI후보

8의학강좌 : 통풍의 진단과 치료

저자 : 유대현 ( Dae Hyun Yoo )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 81권 1호 발행 연도 : 2011 페이지 : pp. 47-49 (3 pages)

다운로드

(기관인증 필요)

초록보기

KCI후보

9논평 : 약인성간손상의 미해결 논점

저자 : 김동준 ( Dong Joon Kim )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 81권 1호 발행 연도 : 2011 페이지 : pp. 50-52 (3 pages)

다운로드

(기관인증 필요)

초록보기

Liver injury due to prescription and nonprescription medications is a growing medical, scientific, and public health problem. Worldwide, the estimated annual incidence rate of Drug-induced liver injury (DILI) is 13.9-24.0 per 100,000 inhabitants. And there is increasing concern about the potential risk for hepatotoxicity from complementary and alternative medicines (CAM) including herbal products because they are unregulated and therefore not standardized with regard to their contents. CAM, including herbal drugs and dietary supplements seem to be major causes of DILI in Asian countries, in contrast to lower incidences in Western countries. However, with increasing use of CAM, DILI from CAM seems to now be a problem allover the world The classification and definition of the causative agents can be difficult. For example, in Korea, herbs might sub-categorize into herbal medications (medications prescribed and compounded by a doctor of oriental medicine), herbal preparations (preparations compounded by an oriental pharmacist), and medicinal herbs or plants (preparation compounded by an unauthorized lay person). Also the division of herbs and folk remedies is unclear at times. Determining hepatotoxicity remains a major challenge in clinical practice due to lack of reliable markers. Standards are lacking for validation of drug causality assessment methods. The RUCAM/CIOMS scale have been proposed to establish a causal relationship between offending drug and liver injury. Although, there is a need to validate a new instrument with an abridged scale that would provide a better approximation to the truth. It would be feasible to develop some refinements to make the RUCAM/CIOMS scale more realistic. (Korean J Med 2011;81:50-52)

KCI후보

10소화기 ; 독성간염의 임상적 고찰과 조직소견

저자 : 임재희 ( Jae Hee Lim ) , 김영석 ( Young Seok Kim ) , 이윤나 ( Yun Nah Lee ) , 김상균 ( Sang Gyune Kim ) , 정승원 ( Soung Won Jeong ) , 장재영 ( Jae Young Jang ) , 이세환 ( Sae Hwan Lee ) , 김홍수 ( Hong Soo Kim ) , 김부성 ( Boo Sung Kim ) , 김희경 ( Hee Kyung Kim )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 81권 1호 발행 연도 : 2011 페이지 : pp. 53-63 (11 pages)

다운로드

(기관인증 필요)

초록보기

Background/Aims: Although many individual cases of toxic hepatitis have been reported, there are few comprehensive systematic studies and few reports of the pathological findings in toxic hepatitis. We studied the clinical characteristics, pathology, and prognosis of patients with toxic hepatitis. Methods: A retrospective analysis examined the medical records of 184 cases of toxic hepatitis diagnosed from January 2004 to January 2010. Liver biopsies were performed in 62 of these cases. Patients were included in this study it they had a RUCAM score ≥4. Results: The incidence was higher in women (n=125) than in men (n=59). The mean age of the patients was 45.9±14.4 years.The most common symptom was jaundice (56/184; 30.4%). The causative agents of the disease included herbal medications (43.5%), traditional therapeutic preparations (33.7%), and prescribed medications (21.7%). The pathological findings of toxichepatitis included necrosis (n=62), cholestasis (n=43), steatosis (n=23), eosinophilic infiltrations (n=22), and ballooning degeneration (n=20). The patients with cholestasis and necrosis were hospitalized longer and showed delayed recovery. The only prognostic factor associated with the hospitalization and recovery periods was the serum total bilirubin at the time of admission (p<0.001). Conclusions: The common pathological findings of toxic hepatitis were necrosis and cholestasis, although these are not specific to toxic hepatitis. Only the total bilirubin at the time of admission was significantly associated with the duration of hospitalization and recovery. (Korean J Med 2011;81:53-63)

123
발행기관 최신논문
자료제공: 네이버학술정보
발행기관 최신논문
자료제공: 네이버학술정보

내가 찾은 최근 검색어

최근 열람 자료

맞춤 논문

보관함

내 보관함
공유한 보관함

1:1문의

닫기